WSU N324 Final QUESTIONS, ANSWERS and
Rationale COMPREHENSIVE VERSION WITHTHE
MOST RECENT AND VERIFIED ANSWERS
GUARANTEED PASS
1. A nurse assesses a clients electrocardiograph tracing and observes that not all QRS complexes
are preceded
by a P wave. How should the nurse interpret this observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The clients chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites.
ANS: D
Normal rhythm shows one P wave preceding each QRS complex, indicating that all
depolarization is initiated
at the sinoatrial node. QRS complexes without a P wave indicate a different source of initiation
of
depolarization. This finding on an electrocardiograph tracing is not an indication of
hyperkalemia, ventricular
tachycardia, or disconnection of leads.
2. A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse
symptoms. Which
,activity modification should the nurse suggest to avoid further slowing of the heart rate?
a. Make certain that your bath water is warm.
b. Avoid straining while having a bowel movement.
c. Limit your intake of caffeinated drinks to one a day.
d. Avoid strenuous exercise such as running.
ANS: B
Bearing down strenuously during a bowel movement is one type of Valsalva maneuver, which
stimulates the
vagus nerve and results in slowing of the heart rate. Such a response is not desirable in a person
who has
bradycardia. The other instructions are not appropriate for this condition.
3. A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify
as being at
greatest risk for atrial fibrillation?
a. A 45-year-old who takes an aspirin daily
b. A 50-year-old who is post coronary artery bypass graft surgery
c. A 78-year-old who had a carotid endarterectomy
d. An 80-year-old with chronic obstructive pulmonary disease
ANS: B
Atrial fibrillation occurs commonly in clients with cardiac disease and is a common occurrence
after coronary
artery bypass graft surgery. The other conditions do not place these clients at higher risk for
atrial fibrillation.
,4. A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to
the possibility
of a serious complication from this condition?
a. Sinus tachycardia
b. Speech alterations
c. Fatigue
d. Dyspnea with activity
ANS: B
Clients with atrial fibrillation are at risk for embolic stroke. Evidence of embolic events includes
changes in
mentation, speech, sensory function, and motor function. Clients with atrial fibrillation often
have a rapid
ventricular response as a result. Fatigue is a nonspecific complaint. Clients with atrial fibrillation
often have
dyspnea as a result of the decreased cardiac output caused by the rhythm disturbance.
5. A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication
should the
nurse expect to find on this clients medication administration record to prevent a common
complication of this
condition?
a. Sotalol (Betapace)
b. Warfarin (Coumadin)
c. Atropine (Sal-Tropine)
d. Lidocaine (Xylocaine)
ANS: B
, Atrial fibrillation puts clients at risk for developing emboli. Clients at risk for emboli are treated
with
anticoagulants, such as heparin, enoxaparin, or warfarin. Sotalol, atropine, and lidocaine are not
appropriate for
this complication.
6. A nurse administers prescribed adenosine (Adenocard) to a client. Which response should the
nurse assess
for as the expected therapeutic response?
a. Decreased intraocular pressure
b. Increased heart rate
c. Short period of asystole
d. Hypertensive crisis
ANS: C
Clients usually respond to adenosine with a short period of asystole, bradycardia, hypotension,
dyspnea, and chest pain. Adenosine has no conclusive impact on intraocular pressure.
7. A telemetry nurse assesses a client with third-degree heart block who has wide QRS
complexes and a heart
rate of 35 beats/min on the cardiac monitor. Which assessment should the nurse complete
next?
a. Pulmonary auscultation
b. Pulse strength and amplitude
c. Level of consciousness
d. Mobility and gait stability
ANS: C
Rationale COMPREHENSIVE VERSION WITHTHE
MOST RECENT AND VERIFIED ANSWERS
GUARANTEED PASS
1. A nurse assesses a clients electrocardiograph tracing and observes that not all QRS complexes
are preceded
by a P wave. How should the nurse interpret this observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The clients chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites.
ANS: D
Normal rhythm shows one P wave preceding each QRS complex, indicating that all
depolarization is initiated
at the sinoatrial node. QRS complexes without a P wave indicate a different source of initiation
of
depolarization. This finding on an electrocardiograph tracing is not an indication of
hyperkalemia, ventricular
tachycardia, or disconnection of leads.
2. A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse
symptoms. Which
,activity modification should the nurse suggest to avoid further slowing of the heart rate?
a. Make certain that your bath water is warm.
b. Avoid straining while having a bowel movement.
c. Limit your intake of caffeinated drinks to one a day.
d. Avoid strenuous exercise such as running.
ANS: B
Bearing down strenuously during a bowel movement is one type of Valsalva maneuver, which
stimulates the
vagus nerve and results in slowing of the heart rate. Such a response is not desirable in a person
who has
bradycardia. The other instructions are not appropriate for this condition.
3. A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify
as being at
greatest risk for atrial fibrillation?
a. A 45-year-old who takes an aspirin daily
b. A 50-year-old who is post coronary artery bypass graft surgery
c. A 78-year-old who had a carotid endarterectomy
d. An 80-year-old with chronic obstructive pulmonary disease
ANS: B
Atrial fibrillation occurs commonly in clients with cardiac disease and is a common occurrence
after coronary
artery bypass graft surgery. The other conditions do not place these clients at higher risk for
atrial fibrillation.
,4. A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to
the possibility
of a serious complication from this condition?
a. Sinus tachycardia
b. Speech alterations
c. Fatigue
d. Dyspnea with activity
ANS: B
Clients with atrial fibrillation are at risk for embolic stroke. Evidence of embolic events includes
changes in
mentation, speech, sensory function, and motor function. Clients with atrial fibrillation often
have a rapid
ventricular response as a result. Fatigue is a nonspecific complaint. Clients with atrial fibrillation
often have
dyspnea as a result of the decreased cardiac output caused by the rhythm disturbance.
5. A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication
should the
nurse expect to find on this clients medication administration record to prevent a common
complication of this
condition?
a. Sotalol (Betapace)
b. Warfarin (Coumadin)
c. Atropine (Sal-Tropine)
d. Lidocaine (Xylocaine)
ANS: B
, Atrial fibrillation puts clients at risk for developing emboli. Clients at risk for emboli are treated
with
anticoagulants, such as heparin, enoxaparin, or warfarin. Sotalol, atropine, and lidocaine are not
appropriate for
this complication.
6. A nurse administers prescribed adenosine (Adenocard) to a client. Which response should the
nurse assess
for as the expected therapeutic response?
a. Decreased intraocular pressure
b. Increased heart rate
c. Short period of asystole
d. Hypertensive crisis
ANS: C
Clients usually respond to adenosine with a short period of asystole, bradycardia, hypotension,
dyspnea, and chest pain. Adenosine has no conclusive impact on intraocular pressure.
7. A telemetry nurse assesses a client with third-degree heart block who has wide QRS
complexes and a heart
rate of 35 beats/min on the cardiac monitor. Which assessment should the nurse complete
next?
a. Pulmonary auscultation
b. Pulse strength and amplitude
c. Level of consciousness
d. Mobility and gait stability
ANS: C
